Issue link: https://www.massageandbodyworkdigital.com/i/1522032
78 m a s s a g e & b o d y wo r k j u l y/a u g u s t 2 0 24 Medication Patches and Implications for Massage Therapy By Ruth Werner Critical Thinking | Pathology Perspectives Imagine you are massaging a client for the first time—she came for a full-body massage with special focus on her low back, which she says "bugs her." You have already worked with her back and the back of her legs, and the session is going well. Now, she is supine. You pick up her arm to work with her shoulder girdle and are surprised to feel an unexpected texture on the medial aspect of her upper arm. On inspection, you find she has a skin-colored square patch, about 2½ inches, midway between her axilla and the medial epicondyle of her humerus. You ask her what it is, and she seems a bit embarrassed: "I didn't think you'd notice. That's my fentanyl patch. It's no big deal. I use it for my back pain, which is much better right now—you are a miracle worker!" WHAT HAPPENS NOW? This story is fictional, but it has elements in common with many stories on my ABMP podcast "I Have a Client Who . . ."—including two podcast episodes that focus on this topic. Transdermal patches are increasingly popular, and they are being used in many new contexts. Soon, we may see them as a strategy to administer vaccines, insulin, genetic therapies, and more. In this article, we'll look at the technology of transdermal delivery systems, with special focus on the use of fentanyl in this form. We have no formally researched data on the safety of massage on or around transdermal patches, so we will conclude by taking the available information and deducing from that some ideas about appropriate accommodations. This column addresses the use of medicated patches that contain fentanyl. If you or someone you care for is experiencing substance abuse, help is available. US Substance Abuse and Mental Health Services Administration (SAMHSA): 800-662-HELP.